# PD-1 blockade + chemoradiation (locally advanced cervical cancer)

Source: https://onco.cc/pairings/io-plus-crt-cervical/  
OnCo record `io-plus-crt-cervical` (Pairing). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Adding pembrolizumab to curative chemoradiation improved survival in high-risk locally advanced cervical cancer (KEYNOTE-A18); durvalumab in a broader population did not (CALLA).

## Summary

Adding pembrolizumab to curative chemoradiation, including brachytherapy, is a combination pairing for high-risk locally advanced cervical cancer that improved overall survival in the phase 3 KEYNOTE-A18 / ENGOT-cx11 / GOG-3047 trial and gained FDA approval for FIGO stage III to IVA disease in 2024. The rationale is that radiation releases tumour antigen and upregulates PD-L1, making the tumour immunogenic, and PD-1 blockade given concurrently and then as maintenance sustains the response. The sister trial CALLA, which used durvalumab in a broader population, was negative, possibly because it enrolled lower-risk patients and used a different drug. Cost limits use of the approach outside high-income countries, and it belongs to the wider family of radiotherapy plus immunotherapy pairings.

## Fields

- Kind: Pairing
- Last checked: 2026-09-07
- Pairs: Pembrolizumab + Brachytherapy
- Type: combination
- Rationale: Radiation-induced antigen release and PD-L1 upregulation make the tumour immunogenic; concurrent and maintenance PD-1 blockade sustains the response.
- Evidence: Phase 3 OS benefit (KEYNOTE-A18); negative sister trial (CALLA).

## Sources

- ClinicalTrials.gov NCT04221945: KEYNOTE-A18 / ENGOT-cx11 / GOG-3047: https://clinicaltrials.gov/study/NCT04221945

## Connected records

- pairings: [Radiotherapy + immunotherapy](https://onco.cc/pairings/radiation-plus-io/)
- cancers: [Cervical cancer](https://onco.cc/cancers/cervical/), [Locally advanced cervical cancer](https://onco.cc/cancers/locally-advanced-cervical-cancer/)
- drugs: [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/)
- trials: [KEYNOTE-A18 / ENGOT-cx11 / GOG-3047](https://onco.cc/trials/keynote-a18/)
- technologies: [Brachytherapy](https://onco.cc/technologies/brachytherapy/)

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